Table Of ContentMILITARY PREVENTIVE MEDICINE:
MOBILIZATION DEPLOYMENT
AND
VOLUME 2
i
FPO
The Coat of Arms
1818
Medical Department of the Army
A 1976 etching by Vassil Ekimov of an
original color print that appeared in
The Military Surgeon, Vol XLI, No 2, 1917
ii
The first line of medical defense in wartime is the combat
medic. Although in ancient times medics carried the caduceus
into battle to signify the neutral, humanitarian nature of
their tasks, they have never been immune to the perils of
war. They have made the highest sacrifices to save the lives
of others, and their dedication to the wounded soldier is
the foundation of military medical care.
iii
Textbooks of Military Medicine
Published by the
Office of The Surgeon General
Department of the Army, United States of America
Editor in Chief and Director
Dave E. Lounsbury, MD, FACP
Colonel, MC, US Army
Borden Institute
Assistant Professor of Medicine
F. Edward Hébert School of Medicine
Uniformed Services University of the Health Sciences
Military Medical Editor
Ronald F. Bellamy, MD
Colonel, US Army, Retired
Borden Institute
Associate Professor of Military Medicine
Associate Professor of Surgery
F. Edward Hébert School of Medicine
Uniformed Services University of the Health Sciences
iv
The TMM Series
Published Textbooks
Medical Consequences of Nuclear Warfare (1989)
Conventional Warfare: Ballistic, Blast, and Burn
Injuries (1991)
Occupational Health: The Soldier and the Industrial
Base (1993)
Military Dermatology (1994)
Military Psychiatry: Preparing in Peace for War (1994)
Anesthesia and Perioperative Care of the Combat
Casualty (1995)
War Psychiatry (1995)
Medical Aspects of Chemical and Biological Warfare
(1997)
Rehabilitation of the Injured Soldier, Volume 1 (1998)
Rehabilitation of the Injured Soldier, Volume 2 (1999)
Medical Aspects of Harsh Environments, Volume 1
(2002)
Medical Aspects of Harsh Environments, Volume 2
(2002)
Ophthalmic Care of the Combat Casualty (2003)
Military Medical Ethics, Volume 1 (2003)
Military Medical Ethics, Volume 2 (2003)
Military Preventive Medicine: Mobilization and
Deployment, Volume 1 (2003)
Military Preventive Medicine: Mobilization and
Deployment, Volume 2 (2005)
v
Deploying a healthy force at any time to any part of the world requires comprehensive and coordinated preventive
medicine services. The challenges and the achievements of military preventive medicine in the US Armed Forces are
embodied by these soldiers crossing a river in Haiti in 1995. They represent a carefully screened cadre of young
Americans who enter military service and benefit from a scientifically sound program to reduce the threat of infectious
diseases and injuries during basic training and deployment. When deployed to a harsh environment such as this one,
they are prepared for potential hazardous exposures—infectious diseases, climatic extremes, chemical and nuclear
exposures, and mental stressors—by military preventive medicine professionals. Military medical research and
development provides their commanders with effective countermeasures. Their health is monitored to detect events
that threaten individual health and operational effectiveness both in the field and in garrison. Military preventive
medicine has always been a fundamental factor for ensuring operational success, but as US military doctrine shifts to
emphasize rapid and relatively smaller deployments of forces accompanied by small medical elements, the preventive
medicine mission takes on a new urgency.
Department of Defense photograph. DoD Joint Combat Camera Center Reference Number -SPT-95-000922.
Photographer: SPC Kyle Davis, US Army
vi
MILITARY PREVENTIVE MEDICINE
MOBILIZATION DEPLOYMENT
AND
Volume 2
Specialty Editor
PATRICK W. KELLEY
Colonel, Medical Corps, U.S. Army (Retired)
Borden Institute
Walter Reed Army Medical Center
Washington, D. C.
Office of The Surgeon General
United States Army
Falls Church, Virginia
United States Army Medical Department Center and School
Fort Sam Houston, Texas
United States Army Medical Research and Materiel Command
Fort Detrick, Frederick, Maryland
Uniformed Services University of the Health Sciences
Bethesda, Maryland
2005
vii
Editorial Staff: Lorraine B. Davis Kathleen A. Huycke
Senior Production Manager Technical Editor
Douglas A. Wise
Senior Layout Editor
Bruce G. Maston
Desktop Publishing Editor
Andy C. Szul
Desktop Publishing Editor
This volume was prepared for military medical educational use. The focus of the information is
to foster discussion that may form the basis of doctrine and policy. The opinions or assertions
contained herein are the private views of the authors and are not to be construed as official or
as reflecting the views of the Department of the Army or the Department of Defense.
Dosage Selection:
The authors and publisher have made every effort to ensure the accuracy of dosages cited herein.
However, it is the responsibility of every practitioner to consult appropriate information sources
to ascertain correct dosages for each clinical situation, especially for new or unfamiliar drugs and
procedures. The authors, editors, publisher, and the Department of Defense cannot be held
responsible for any errors found in this book.
Use of Trade or Brand Names:
Use of trade or brand names in this publication is for illustrative purposes only and does not
imply endorsement by the Department of Defense.
Neutral Language:
Unless this publication states otherwise, masculine nouns and pronouns do not refer exclusively
to men.
CERTAIN PARTS OF THIS PUBLICATION PERTAIN TO COPYRIGHT RESTRICTIONS.
ALL RIGHTS RESERVED.
NO COPYRIGHTED PARTS OF THIS PUBLICATION MAY BE REPRODUCED OR
TRANSMITTED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR MECHANICAL
(INCLUDING PHOTOCOPY, RECORDING, OR ANY INFORMATION STORAGE AND
RETRIEVAL SYSTEM), WITHOUT PERMISSION IN WRITING FROM THE PUBLISHER OR
COPYRIGHT OWNER.
Published by the Office of The Surgeon General at TMM Publications
Borden Institute
Walter Reed Army Medical Center
Washington, DC 20307-5001
Library of Congress Cataloging-in-Publication Data
Military preventive medicine : mobilization and deployment / specialty editor, Patrick W. Kelley.
p. ; cm. -- (Textbooks of military medicine)
Includes bibliographical references and index.
1. Medicine, Military. 2. Medicine, Preventive. 3. Military hygiene. I. Kelley, Patrick
W. II. United States. Dept. of the Army. Office of the Surgeon General. III. Series.
[DNLM: 1. Military Medicine. 2. Preventive Medicine. UH 600 M6444 2003]
RC971.M64 2003
616.9’8023--dc21
2003048099
PRINTED IN THE UNITED STATES OF AMERICA
10, 09, 08, 07, 06, 05, 04, 03 5 4 3 2 1
viii
Contents
Foreword by The Surgeon General xvii
Preface xix
SECTION 5: Epidemiology in the Field 705
31. Disease and Nonbattle Injury Surveillance: Outcome Measure for Force Health
Protection 707
32. Outbreak Investigation 723
33. Epidemiologic Measurement: Basic Concepts and Methods 755
34. Laboratory Support for Infectious Disease Investigations in the Field 783
SECTION 6: Infectious Diseases of Concern 801
35. Diseases Transmitted Primarily by Arthropod Vectors 803
36. Diseases Transmitted Primarily from Animals to Humans 937
37. Diseases Transmitted by Food, Water, and Soil 999
38. Diseases Spread by Close Personal Contact 1117
39. Diseases Controlled Primarily by Vaccination 1213
40. Principles of Infection Control and Prevention During Military Deployment 1249
SECTION 7: Preventive Medicine Efforts Following Disasters 1267
41. The Challenge of Humanitarian Assistance in the Aftermath of Disasters 1269
42. Military and Public Health Aspects of Natural Disasters 1289
43. Complex Emergencies 1315
44. Public Health Perspectives Related to Technological Disasters and Terrorism 1337
45. The International Humanitarian Response System and the US Military 1351
46. Domestic Disaster Response: FEMA and Other Governmental Organizations 1363
47. Nutritional Assessment and Nutritional Needs of Refugee or Displaced
Populations 1375
SECTION 8: Postdeployment 1393
48. Psychological Aspects of Deployment and Reunion 1395
49. Medical Issues in Redeployment 1425
Abbreviations and Acronyms xxiii
Index xxvii
ix
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